Six Months Of Diarrhea19/05/2019
Up to 15 times of the day, the man has to go to the toilet. He’s suffering from a bloody diarrhoea. For three months he endures this until he consults his family doctor. The physician makes a bacterial culture is negative. He prescribes the patients a broad spectrum antibiotic to take for seven days. A healthy 67-Year-old of which, however, is not.
He makes a further three months to pass before he is looking for a medical help: he Now reports in the emergency room of the University hospital of Dijon-Bourgogne. In addition to the case, have set more problems. The man has a fever for two days. In addition, his upper it hurts the belly. Since the beginning of the complaints he has lost around five kilos, he tells the Doctors.
The medical record that the Patient takes a drug against chronic high blood pressure. He is retired and lives together with his partner.
The location of the pain in the upper abdomen allows the Doctors to a Problem with the liver close. The man, however, is not looking for yellow, which may be associated with liver diseases. Also, the Organ is not enlarged pathologically, the Team reported to Capucine Martin’s in the journal “BMJ Case Reports”.
A blood test revealed that the number of white blood cells is increased, as is the so-called C-reactive Protein. Both speaks for an infection against which the body is fighting.
Abscesses in the liver
By means of a computer tomography the doctors abdomen and the pelvic area of the man view. Be the colon shows signs of chronic inflammation. In the liver, you will discover two Abscesses around six to seven inches in diameter. From this vacuum, a reddish liquid.
To this point, you cannot say with certainty what caused the Abscesses. Most likely, that are incurred as a result of a bacterial infection in the gastro-intestinal tract.
Less likely but also possible is that the bacteria attacked his heart and then via the bloodstream to the liver to have achieved. And, most recently, doctors cannot rule out the possibility that, instead of bacteria, other disease-plug pathogens behind the symptoms.
Further Tests will clarify this. In the blood no bacteria can thus be detected. In a stool sample, no traces of the typical bacterial pathogens causing diarrhea are to be found.
Also, the liquid from the liver abscess seems to be free of bacteria. However, the Doctors were able to prove therein the genome of a pathogen. It is a protozoan, the amoeba Entamoeba histolytica. Further Tests confirm this. The man suffers from a disease that occurs in Europe is extremely rare: the so-called amoebic dysentery. The unicellular organisms have colonized his gut and causing his discomfort. In addition, they are the Abscesses in the liver, and even this is not an atypical result of an infection with E. histolytica.
How did infected man?
Now the Doctors want to know where the man with the amoeba infected. In the European cases, the persons Concerned were, as a rule, in the tropics or subtropics. But the 67-Year-old has never been outside of Europe.
However, his partner was in regions where amoebic dysentery occurs in India, Vietnam and South America. Also, you once had a Partner who had amoebic dysentery. You never had symptoms, but a Test shows that she carries the disease-causing organisms. This is not unusual: 90 percent of the people, an infection with E. histolytica does not cause any symptoms, reports the German society for tropical medicine in their guideline for the treatment of the disease. The Affected can shed the pathogen and infect others. Poor hygienic conditions for the Transfer of the amoeba, such as contaminated drinking water provide. The parasites can also be used during intercourse passed. That was when the 67-year-old Frenchman is probably the case.
The antibiotic had gotten to the man first, because of the suspicion of a bacterial infection the Doctors immediately – the drug does not help against amoebae. He receives, instead, a means against these pathogens. Within 48 hours, the liver disappear pain, the bloody disappears by case, and his laboratory values reverting back to normal. His partner takes the medication as well.
In a follow-up appointment two months later, the man is alive and well, and there are no traces of the pathogens are no longer detectable.